动脉瘤性蛛网膜下腔出血后迟发性脑缺血病理生理学机制的研究现状

Current status of research on the pathophysiological mechanisms of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

摘要:

动脉瘤性蛛网膜下腔出血（aSAH）是仅次于脑梗死、脑出血的第三大神经系统危急重症，其并发症迟发性脑缺血（DCI）是导致aSAH患者住院时间延长、神经功能预后较差及病死率较高的重要原因。以往的研究认为脑血管痉挛（CVS）是导致DCI的唯一因素，现有研究证实，DCI是多种机制相互作用的结果。该文总结了目前aSAH后导致DCI的病理生理学机制相关研究，目的是通过这些机制寻求能早期预警DCI发生的指标和治疗靶点，提高患者的预后。

Abstract:

Aneurysmal subarachnoid hemorrhage （aSAH） is the third most critical neurological condition， following cerebral infarction and intracerebral hemorrhage. Its complication， delayed cerebral ischemia （DCI）， is a significant cause of prolonged hospitalization， poor neurological outcomes， and high mortality in patients with aSAH. Previous studies considered cerebral vasospasm as the sole factor leading to DCI， while current research has confirmed that DCI is the result of the interaction between multiple mechanisms. This article summarizes the pathophysiological mechanisms leading to DCI after aSAH， in order to identify early warning indicators and treatment targets for DCI and improve the prognosis of patients.